Intrauterine Devices : Access For Women In The Us
Intrauterine devices are one of the most effective forms of reversible contraception. IUDs, along with implants, are known as long-acting reversible contraception because they can be used to prevent pregnancy for several years. IUDs have been used in the U.S. for decades, but a safety controversy in the 1970s prompted the removal of all but one IUD from the U.S. market by 1986. The first new generation IUD was introduced to the U.S. market in 1988, following revised Food and Drug Administration safety and manufacturing requirements. Recent controversies have focused on the mechanism of action of IUDs, the high upfront costs for the device, and variability in insurance coverage and access. This fact sheet reviews the various IUDs approved by the FDA, awareness, use, and availability of IUDs, and key issues in insurance coverage and financing of IUDs in the U.S.
How About The Non
The Paragard non-hormonal IUD prevents pregnancy thanks to a tiny copper filament wrapped around the T. Paragard contains no hormones of any kindits the only super-effective non-hormonal birth control method around . Paragard also works as highly effective emergency contraception, so if youre considering an IUD and have had unprotected penis-in-vagina sex in the last 5 days but dont want to be pregnant, that could be another point in its favor.
Most people who use Paragard have heavier, longer, or crampier periods, especially for the first few months. After 6 months, many Paragard users periods return to normal. If you already have really heavy or uncomfortable periods, or you are anemic , you might prefer a hormonal IUD.
The bottom line? IUDs are safe, effective, and totally reversible. Whichever IUD you and your provider decide is best for you, we all win with more long-lasting, low-maintenance birth control options available.
Sara Kennedy, MD, MPH, is an Obstetrician/Gynecologist in Oakland, California. Originally from Pennsylvania, Sara has studied and lived around the world, including a residency at Northwestern University in Chicago and a masters degree in Australia, where she met her husband! Sara is passionate about womens health, particularly helping women in vulnerable situations obtain the knowledge and resources they need in order to control their reproductive health.
Is It Okay To Suppress Periods
Hormonal IUDs suppress bleeding, which inevitably raises the question: Is it okay to not have a period?
Theres no medical reason to bleed monthly, and certainly, no reason to bleed monthly on the pill because pill-bleeds are not periods.
There is, however, a reason to ovulate monthly because ovulation is how women make hormones. Normally, ovulation leads to a bleed, except in the case of a hormonal IUD, which permits ovulation but can suppress bleeding.
Tip: With the pill, you bleed but dont cycle. With the hormonal IUD, you can cycle but not bleed.
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What Are The Types Of Iuds
There are 5 different brands of IUDs that are FDA approved for use in the United States: Paragard, Mirena, Kyleena, Liletta, and Skyla.
These IUDs are divided into 2 types: copper IUDs and hormonal IUDs .
The Paragard IUD doesnt have hormones. Its wrapped in a tiny bit of copper, and it protects you from pregnancy for up to 12 years.
The Mirena, Kyleena, Liletta, and Skyla IUDs use the hormone progestin to prevent pregnancy. Progestin is very similar to the hormone progesterone that our bodies make naturally. Mirena works for up to 7 years. Kyleena works for up to 5 years. Liletta works for up to 7 years. Skyla works for up to 3 years.
Even With All Their Benefits Iuds Arent For Everyone Here Are A Few Reasons Why A Different Birth Control May Be Better For You
Maybe you like the sense of control that comes with taking a pill every day or youd prefer a method that you can start or stop at any time . IUDs have been established as safe and effective for most birth control users, but you also need to feel completely comfortable with your birth control method.
Its true that IUDs come with a small risk of expulsion, which is basically when your body starts to push out your IUD. According to the limited research on IUD expulsion, the average incidence rate is between 3 and 5 percent of all IUD users and 5 to 22 percent of adolescent IUD users, says the American Congress of Obstetricians and Gynecologists. But its important to note that this research was done in 2009 and 2010 and only looked at Mirena and ParaGard, not any of the newer options that have been developed over the last several years.
IUDs also come with the risk of perforation, which happens when an IUD pushes through your uterus, although this is even less likely than the chance of expulsion. One study published in the journal Conception in 2015 found that out of 61,448 women who had an IUD, only 81 reported having a perforation.
Technically, you could use an IUD until youre ready to start trying and be just fine, but thats not exactly cost-effective, Dr. Streicher says. IUDs can be expensive if your insurance doesnt cover them.
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Nexplanon Vs Mirena Side By Side Comparison
Nexplanon and Mirena are progestin-containing drugs that can prevent pregnancy. Despite their different forms, both drugs have similar effects. Their features can explored in the table below.
|Is there a generic?|
|Is it covered by insurance?|
|SingleCare Discount Price|
|Can I use while planning pregnancy, pregnant, or breastfeeding?|
What Are The Benefits Of Paragard Iud
Paragard has a 99% success rate. Once this copper IUD is inserted, the chances of getting pregnant are slim. Those looking for an effective birth control solution can be confident in knowing that they are well protected with Paragard. This IUD permits regular ovulation in women as it doesnt add any extra hormones into the body.
Much like other IUDs currently offered in Canada, the Paragard requires no maintenance once inserted. Medical professionals recommend a follow-up visit 4 -6 weeks after the procedure so that the positioning of the device can be checked.
After the follow-up appointment, the only maintenance required is a quick monthly check if the two thin strings attached to the end of the IUD.
Since this IUD uses copper and not hormones to prevent pregnancy, the side effects that are commonly associated with hormonal IUDs are non-existent.
Some individuals may want an IUD, but either cannot use a hormonal one due to other medical problems, or simply prefer not to deal with any potential side effects that are common in IUDs with hormones in them.
With the copper IUD remaining effective for up to 10 years, those who are sexually active need not worry about other methods of protection. No searching for condoms, and no birth control pills to take.
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How Quickly Does It Work
The Mirena IUD works immediately if you have it inserted within 7 days after the start of your period.
If you have your Mirena inserted at any other time during your menstrual cycle, you will need to use a backup birth control method during the first week after insertion. You will have pregnancy protection after these 7 days.
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Can My Iud Fall Out
Your doctor will check your device during your regular office visits. Your cervix should hold the IUD in place, but in rare cases, it can fall all the way or part of the way out.
This is more likely if:
- You donât have children.
- YouÃ¢re under 20 years old.
- You had the IUD put in right after having a baby or after having a second-trimester abortion.
- You have fibroids in your uterus.
- Your uterus is an unusual size or shape.
IUDs are more likely to come out during your period. You may see the device on a pad or tampon. Check periodically to make sure you can feel the strings. If they feel shorter or longer or if you can feel the IUD itself pushing against your cervix, it may have moved. If this happens, contact your doctor.
Where Can I Get It And What Are Costs
IUDs are available at UHS.
Please call UHS at 734-764-8320 to schedule in-person services, video visits for contraceptive counseling, for information on the e-consultation for IUD, or for any other questions.
If you already know you want an IUD, you can do e-consultation:
You should not use an IUD if you:
- Have or may have a current STI or other pelvic infection
- Think you might be pregnant
- Have cervical or uterine cancer
- Have unexplained vaginal bleeding
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Using An Ius After Giving Birth
An IUS can usually be fitted from 4 weeks after giving birth . You’ll need to use alternative contraception after the birth until the IUS is put in.
In some cases, an IUS can be fitted within 48 hours of giving birth. It’s safe to use an IUS when you’re breastfeeding, and it will not affect your milk supply.
What Are The Disadvantages
- Some people feel pain, cramps or dizziness when the IUD is put in or taken out.
There are some risks from having an IUD put in:
- There is a small risk of infection when an IUD is put in
- There is a very small risk of damage to the uterus
- A copper IUD might give you more bleeding and cramping during your period, but this usually gets better over time
- The copper IUD can cause an allergic reaction, but this is very rare
- The hormonal IUD might give you irregular or light bleeding
- The IUD can sometimes come out by itself . You can check the threads are still in the right place at any time.
Pros Of Hormonal Iuds:
Unlike all other types of hormonal birth control, hormonal IUDs do not completely suppress ovulation and ovarian hormones. According to one study, Mirena suppresses ovulation in 85 percent of cycles during the first year , and then in 15 percent of cycles after that. Lower dose IUDs permit ovulation more of the time. Because hormonal IUDs permit ovulation at least some of the time, they are probably the best option of all types of hormonal birth control.
Tip: Ovulation is beneficial because its how women make hormones.
Compared to pills and implants, hormonal IUD delivers a lower dose of a contraceptive drug. The blood level of levonorgestrel in Mirena-users is about one-tenth of pill-users. Unfortunately, even that low dose can cause side effects .
Hormonal IUDs are more effective than almost any other method of contraception, with a failure rate of just 0.7 percent.
After insertion, you dont need to do anything or take anything, and IUDs lasts three years or five years .
In theory, fertility returns to normalalmost as soon as a hormonal IUD is removed.
Hormonal IUDs reduce menstrual flow by at least 90 percent, and thats a huge pro for heavy menstrual bleeding.
Hormonal IUDs can relieve some of the symptoms of endometriosis. For other endometriosis treatment ideas. .
What Is The Mirena Iud
Mirena® is a hormonal IUD. The device releases a small amount of the hormone progestin into the uterus. Of the four brands of hormonal IUDs, Mirena® was the first to become available. It provides longer-lasting pregnancy protection than other hormonal IUDs up to five years compared to three or four years for other brands. Studies show that Mirena® can be effective for up to seven years, even though it is approved to be used for only five years. Liletta is an IUD that is very similar to Mirena®. They are both made with the same type and dose of progestin, so they work the same way. Liletta is approved for up to four years of use.
Mirena® birth control prevents pregnancy by thickening cervical mucus. This makes it more difficult for the sperm to reach an egg. Women who use Mirena® may also have a thinner uterine lining. Having a thinner uterine lining helps protect against uterine cancer.
Because Mirena® uses hormones, your period may come less frequently or stop entirely. This is considered a benefit of Mirena® having less bleeding is not considered harmful. Sometimes doctors recommend Mirena® as a way to help women manage heavy or painful periods. This IUD may also improve endometriosis or fibroid symptoms.
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Who Can Get An Iud
Most people can use an IUD, including those who are young and those who have not had children.
Hormonal IUDs are a really good option if you have heavy or painful periods.
If you have an infection, you should get it treated before you get an IUD put in.
If you have heavy or painful periods you should not get a copper IUD because it might make them worse.
What We Know About Iuds
Theres a lot of misinformation about IUDs, and a lot of horror stories regarding the long-term effects of IUDs. Many of these horror stories are worst-case scenarios. Here are the statistics regarding the complications women are apprehensive about before getting IUDs inserted:
- Fewer than 10% of women will experience their IUD falling out of place, with some estimates as low as 0.5%. Sexual partners should be able to feel the strings on the IUD and can check the IUDs placement before intercourse if theyre worried about it.
- The scariest complication of IUDsthe risk of the IUD puncturing the uterine wallis also extremely rare, occurring in 0.1% of women.
However, the best part of having an IUD is the fact that they are effective over long periods of time but can easily be removed if and when a woman decides to start trying for a baby. The procedure to have an IUD inserted is a brief outpatient procedure, and its no more invasive than a gynecological exam.
While some women find the insertion process to be painful, the procedure takes less than half an hour to perform and lingering pain that day is no worse than typical menstrual cramping. The benefits of an IUD is that, unlike condoms or the pill, no one has to remember the contraceptive on a regular basis. Once an IUD has been inserted, its effective for several years.
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Who Can Use A Hormonal Iud
- Most women who want a reliable, long-term contraceptive
- Women who haven’t had a pregnancy
- Women who have decided to not have any more children
- Women who would like to space out their pregnancies
- Women who are breastfeeding
You should not use the hormonal IUD if:
- you might be pregnant
- you have a recent infection called pelvic inflammatory disease
- you have unusual bleeding from your vagina
- you have a history of breast cancer or some serious liver conditions
Talk to your doctor before deciding to use a hormonal IUD if you have:
- a recent sexually transmitted infection
- fibroids or other conditions that change the shape of your uterus
- previous problems with an IUD
- you are unable to have a follow-up check-up after the IUD is put in
Are There Any Side Effects From Using The Hormonal Iud
- When the hormonal IUD is first inserted some users have period type cramping that usually settles after a few days.
- Your vaginal bleeding pattern will change. Spotting or frequent bleeding is common in the first 3 6 months. By 6 months most users will have a light regular period or no bleeding at all .
- Sometimes the IUD can fall out. This is more common in the first 3 months of it being inserted.
Other possible side effects for a small number of users can include:
- sore/ tender breasts
- mood changes.
These side effects nearly always settle with time. The hormonal IUD has not been shown to cause weight gain.